TOUGH CHOICES: Victor and Maria Roa kiss their daughter, Hazelle, in San Francisco on Monday. Hazelle Roa has a little-known genetic disorder that is likely to require specialized medical care in the United States, but her parents are illegal immigrants from Mexico who have been ordered out of the country by immigration officials.

SAN FRANCISCO – Seventeen-month-old Hazelle Roa has curly black hair in a pink lacy bow – and a bright yellow feeding tube taped to her cheek.

The toddler has a little-known genetic abnormality – a typo in her body’s operating instructions that translates into a too-narrow heart artery, difficulty swallowing food, and a thyroid deficiency.

Doctors have been readying Hazelle and her family for a delicate procedure Thursday that will expand her constricted artery. Two weeks later, her parents are scheduled to report to U.S. Immigration and Customs Enforcement with their bags packed for a one-way trip to Mexico.

Although their daughter’s an American citizen, Victor and Maria Roa are illegal immigrants who have been served with an order to surrender by federal authorities. The Roas are among thousands of families split by immigration status because the parents are undocumented while their children are American born and raised.

But this case comes with a twist: Hazelle’s rare medical condition, which her doctors contend will require specialized, lifelong care.

“It’s so difficult as a father to think of what will happen to her if we’re detained and she’s in the hospital,” said Victor Roa, who juggles jobs chopping vegetables in a restaurant and driving a truck on nights and weekends. “If a child is sick, you never want to separate from her. It’s impossible.”

But anti-immigration activists say the case argues against the current policy that grants automatic citizenship to everyone born in the United States.

“These people can sneak across the border, they have absolutely no connection with this country, and all of a sudden you have a brand new U.S. citizen on your hands that the rest of us become responsible for,” said Ira Mehlman, with the Federation for American Immigration Reform. “Nobody feels good about saying no to a child, but the needs outweigh the available resources and difficult decisions have to be made.”

What happens to American children of deportable immigrants – whether they go with their parents or stay with relatives or the state – is up to the family, said Lori Haley, spokeswoman for U.S. Immigration and Customs Enforcement.

But the Roas are stuck. They don’t want to take their daughter away from the team of top-notch physicians at the University of California, San Francisco Medical Center who have followed her case from the beginning. And they can’t imagine leaving her behind.

They’ve defied orders to get out of the United States, and now they’re staying up nights wondering what will happen, feeling their options shrink.

To cover their legal bills, they’ve sold many of their belongings, from furniture to shoes, in yard sales and to friends. Hazelle’s medical expenses are covered by a state program that helps low-income children with chronic conditions.

The Roas crossed the border illegally in 1990, and following poor legal advice, entered a frivolous case for asylum. In November 2004, after many twists and turns through immigration courts, the Board of Immigration Appeals ruled they were in the United States illegally and gave them the option of leaving on their own, Haley said.

When they failed to go by the deadline, the request became a deportation order. In May 2007, a little more than a year after Hazelle’s birth, they got a letter telling them to surrender to immigration authorities on June 26.

The couple despaired. Two weeks before the deadline, they found a new attorney, David Lunas, who has a new strategy – Hazelle’s health. He argues that the removal order should be canceled under a rule that allows undocumented immigrants to stay if their departure would cause extreme hardship to an American citizen.

On the day before the Roas were scheduled to leave, Lunas requested a stay of deportation. It was rejected.

“They didn’t find the condition the child is in, to be without her parents, results in real hardship,” Lunas said.

Hazelle’s doctors, who have written a number of letters in support of her family, said the Roas are clearly a loving family and their toddler needs their care.

“She’s firmly attached to her parents, and for her to tolerate being in the hospital, having procedures done, she needs to have her parents there,” said Stephen Wilson, medical director for the pediatric unit at UCSF, one of the nation’s top-rated hospitals. “The world of a 17-month-old is her parents.”

The physicians make a strong case for keeping the child, and her parents, in California.

“This isn’t a routine case of pneumonia or asthma, something any old physician has experience with,” Wilson said in an interview.

After some discussion with immigration authorities, the Roas and their attorney went to the immigration enforcement office on July 3 to request a year’s stay. Six hours later, they left with a new deadline – July 26.

That allows the Roas to be by Hazelle’s side through Thursday’s exploratory heart procedure, when a thin catheter carrying a tiny balloon will open her artery, and a diminutive camera will tell doctors if she needs further surgery.

It also give Lunas time to fight for a longer stay, or for the cancellation of their deportation order under the hardship rule.

“This is one of the provisions that’s there for humanitarian reasons, one of the few compassionate provisions there are,” Lunas said. “And theirs is the quintessential cancellation-of-removal case.”

ICE officials say the agency reviews individual appeals case by case. In the meantime, Hazelle’s parents are left to cope with the uncertainty and financial burden of their complicated situation.

“We want immigration judges to understand we’re responsible parents, to look at our case and let us stay and take care of our daughter,” said Maria Roas. “No state agency is going to do the job raising her that we can do.”

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